Interscalene block applied by an experienced anesthesiologist has a good anesthetic effect, a long duration of action, and less postoperative pain after arthroscopic shoulder procedures independent of surgery type and operation duration

This study aims to evaluate the severity of postoperative pain and the time to the onset of pain after arthroscopic surgical treatment of rotator cuff tear or instability under interscalene block. Patients and methods: Between October 2015 and June 2016, a total of 172 patients (82 males, 90 females; mean age: 47.9±16.9 years; range, 15 to 83 years) who underwent shoulder arthroscopy under interscalene block by a single surgeon were retrospectively analyzed. The relationship between the postoperative 24-h Visual Analog Scale (VAS), the time to the onset of pain with the type of surgical procedure (rotator cuff repair, n=101 or instability surgery, n=71), and the duration of surgery (<30 min n=92; ≥30 min n=80) was examined. Results: No significant relationship was found between the type of surgical procedure, VAS scores, and the onset of pain after the block (p=0.577 and p=0.780, respectively). No significant relationship was found between the operation duration, and VAS, and the onset of pain after the block (p=0.570 and p=0.408, respectively). The mean duration until the start of postoperative pain was 734±313 (range, 60 to 1,440) min. There was no statistically significant difference in the need for rescue analgesics at the postoperative 24th h and the duration of surgery between the two groups (p=0.393 and p=0.675, respectively). Conclusion: Our study results show no significant difference in the time for the onset of postoperative pain and the VAS scores according to the characteristics of the surgical procedure, operation duration, or age and sex of the patient. Shoulder arthroscopy performed by experienced surgeons under interscalene block eliminates the need for analgesics within the first 12 h postoperatively

Clinical and polysomnographic evaluation of sleep breathing disorders in patients with sarcoidosis

YÖK Tez No: 621334Amaç: Çalışmada sarkoidoz hastalarında obstrüktif uyku apne sendromu (OSAS) sıklığının ve buna etkili olan klinik faktörlerin değerlendirilmesi amaçlandı. Gereç ve Yöntem: Kliniğimizde tanı almış ardışık 60 sarkoidoz hastasına uykuda OSAS riskini değerlendirilmek için Epworth Uykululuk Ölçeği, Stanford Uykululuk Ölçeği, Pitsburg Uyku Kalitesi Ölçeği, Berlin Anketi, STOP ve STOPBANG anketleri uygulandı ve polisomnografi (PSG) testi yapıldı. Bulgular: Yaş ortalaması 50±11 olan 45 (%75) kadın, 15 (%25) erkek toplam 60 sarkoidoz hastası çalışmaya dahil oldu. Olguların 54'üne polisomnografi yapıldı. Polisomnografi yapılan olguların %70,4'üne (38/54) OSAS tanısı kondu. OSAS tespit edilen sarkoidoz olgularında ortalama yaş daha yüksek bulundu (47±13'e karşı 54±11, p=0,041). OSAS'lı sarkoidoz olguları daha şişmandı (VKİ 29,0±4,6 ya karşı 31,9±4,4 p=0,034). Pitsburg uyku kalitesi ölçeği, STOP ve STOP-BANG anketlerinde klinik açıdan yüksek riskli bulunan sarkoidoz hastalarında polisomnografiyle OSAS sıklığı anlamlı olarak daha yüksek bulundu (sırasıyla p=0,024, p<0,001ve p<0,001). Polisomnografi yapılan sarkoidoz olgularında evre 1'de %38,5 (5/13), evre 2'de %77,8 (28/36), evre 3'de ise tüm olgularda (5/5) OSAS tespit edildi. Sarkoidoz evresi arttıkça OSAS sıklığının arttığı tespit edildi (p=0,003). Sarkoidoz evresi arttıkça apne hipopne indeksi (AHİ) ortalaması da istatistiksel açıdan anlamlı olarak artmaktaydı (p=0,043). Sarkoidoz evresiyle AHİ'nin pozitif korelasyon gösterdiği tespit edildi (p=0,003, r=0,391). Tedavi gören sarkoidoz olgularında OSAS oranları hiç tedavi görmemiş olanlara göre istatistiksel açıdan anlamlı olarak daha yüksek bulundu. (%87,5 e karşı %56,7, p=0,018) . Yapılan multivaryant lojistik regresyon analizinde sarkoidoz olgularında OSAS riskini artıran tek bağımsız risk faktörünün hastalığın evresi olduğu tespit edildi (p=0.026). Sonuç: Sarkoidozda hastalığın evresiyle artan yüksek oranlarda OSAS tespit edildi. Özellikle ileri yaştaki, obez, steroid tedavisi alan ve akciğer parankim tutulumu olan (evre 2 ve 3) sarkoidoz olgularının OSAS riski açısından klinik ve polisomnografik olarak değerlendirilmesi gerektiği kanaatindeyiz. Sarkoidozda yüksek OSAS prevalansının olası nedenlerini ortaya koymak için daha büyük ve kapsamlı çalışmalara ihtiyaç vardır.Aim: The aim of the study was to evaluate the frequency of obstructive sleep apnea syndrome (OSAS) in sarcoidosis patients and the clinical factors that effect it. Patients and methods: Epworth Sleepiness Scale, Stanford Sleepiness Scale, Pittsburgh Sleep Quality Scale, Berlin questionnaire, STOP and STOPBANG questionnaires were performed on 60 consecutive sarcoidosis patients in our clinic and polysomnography (PSG) test was performed to evaluate the risk of sleep OSAS. Results: A total of 60 sarcoidosis patients, 45 (75%) women and 15 (25%) men with an average age of 50±11, were included in the study. 54 of the cases were polysomnographed. In 70.4% (38/54) of polysomnographed cases, OSAS were diagnosed. The mean age was higher in sarcoidosis patients with OSAS (47±13 vs. 54±11, p=0.041). Sarcoidosis patients with OSAS were fatter (BMI 29.0±4.6 vs. 31.9±4.4 p=0.034). The frequency of OSAS with polysomnography was significantly higher in patients with clinically high risk sarcoidosis in the Pittsburgh sleep quality scale, STOP and stop-BANG surveys (P=0.024, p<0.001 and p<0.001, respectively). In sarcoidosis patients with polysomnography, OSAS were detected in 38.5% (5/13) in Stage 1, 77.8% (28/36) in Stage 2, and in all cases (5/5) in Stage 3. The frequency of OSAS was found to increase as sarcoidosis phase increased (p=0.003). As the sarcoidosis phase increased, the mean of the apnea hypopnea index (AHI) also increased statistically significantly (p=0.043). AHI was found to be positively correlated with sarcoidosis stage (p=0.003, r=0.391). The rates of OSAS were statistically significantly higher in patients with sarcoidosis who were treated than those who had never been treated. (87.5% vs. 56.7%, p=0.018). Multivariant logistic regression analysis found that the only independent risk factor that increased the risk of OSAS in sarcoidosis cases was the stage of the disease (p=0.026). Conlusion: High rates of OSAS were detected in sarcoidosis, which increased with the stage of the disease. We believe that sarcoidosis patients with advanced age, obesity, steroid treatment and lung parenchyma involvement (stages 2 and 3) should be evaluated clinically and polysomnographically in terms of OSAS risk. Larger and comprehensive studies are needed to establish the possible causes of high OSAS prevalence in sarcoidosis

A case with diffuse granulomatous inflammation mimicking malignancy [Maligniteyi taklit eden yaygın granülomatöz inflamasyon olgusu]

A 59-year-old female patient was admitted to outpatient clinic with a 3-week dry cough and a 2-month exercise dyspnea (MRC 2). Within the last 3 months there was a loss of 5 kg. She has never smoked. She was a housewife. In thoracic computed tomography of the patient’s postero-anterior chest x-ray, the right lower quadrant is the opacity of the right atrium. A large number of nodules (5 mm in size) in both upper lobes of the lungs, and a common reticulonodular dancer in the middle lobe of the right lingula. The desired positron emission tomography of the patient with malignancy pre-diagnosis; right lobe of the lungs, reticular densities in the left lung, gastroesophageal junction, stomach fundus and large curvature in the dorsal wall of the nasopharynx, bilateral cervical lymphadenopathies, bilateral cervical lymphadenopathies, bilateral lymph nodes, right lobe of the lungs, right scapula and left iliac bone intense hypermetabolic involvement was detected. The axillary lymph node dissection was diagnosed as granulomatous lymphadenitis. The patient was accepted as sarcoidosis, inhaled steroid therapy was initiated and followed. © 2017, Duzce University Medical School. All rights reserved

Maligniteyi Taklit Eden Yaygın Granülomatöz İnflamasyon Olgusu

Elli dokuz yaşında kadın hasta 3 haftadır devam eden kuru öksürük ve 2 aydır olan efor dispnesi (MRC 2) ile polikliniğimize başvurdu. Son 3 ay içerisinde 5 kg kaybı mevcuttu. Hiç sigara içmemişti. Mesleği ev hanımı idi. Hastanın postero-anterior akciğer grafisinde sağ alt zonda sağ atriyum kenarını silen opasite olması üzerine çekilen toraks bilgisayarlı tomografisinde; her iki akciğer üst loblarda büyüğü 5 mm olmak üzere birkaç adet nodül, solda lingula ve sağda orta lobda yine yaygın retikülonodüler dansiteler izlendi. Hastanın malignite ön tanısıyla istenen pozitron emisyon tomografisinde; nazofarenks dorsal duvarında, bilateral servikal lenfadenopatilerde, her iki akciğerde parankim nodüllerinde, sağ akciğer hiler alanda, sol akciğerde retiküler dansitelerde, gastroözafagial bileşkede, mide fundus ve büyük kurvaturunda, karaciğerde, iliak istasyonlarda multipl lenfadenopatilerde, sağ skapula ve sol iliak kemik iliğinde yoğun hipermetabolik tutulum saptandı. Yapılan axiller lenf nodu diseksiyonu granülomatöz lenfadenit olarak saptandı. Hasta sarkoidoz olarak kabul edildi, inhale steroid tedavisi başlandı ve takibe alındı

An investigation of serum irisin levels and iflammatory markers in fibromyalgia syndrome

WOS: 000500484500004PubMed: 31909378OBJECTIVE: In the present study, we aimed to compare serum irisin levels in patients with fibromyalgia syndrome (FMS) and healthy control subjects and also investigate the relationship between irisin, disease activity and inflammation markers in patients. METHODS: A total of 84 women, including 48 patients who were diagnosed with FMS and 36 healthy controls, were included in this study. The demographic characteristics of the patients and control group were recorded. VAS for pain and the Fibromyalgia Impact Questionnaire for the assessment of the physical function of the patients, SF36 was used for quality of life, and accompanying Beck Depression Inventory to assess depression was used. Blood samples were taken for analysis that irisin, and inflammatory markers of the erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), high-sensitivity C-reactive protein (hs-CRP) and neutrophil/lymphocyte ratio (NLO). Serum irisin levels were determined using the Enzyme-Linked Immunosorbent Assay (ELISA) method. RESULTS: Serum irisin level of the patients with FMS had no significant differences compared with the healthy control group. When we compared the values of ESR, CRP, hsCRP, NLO with FMS patients and healthy controls, there was no significant difference found between them (p>0.05). There was no significant correlation between inflammatory markers and level of serum irisin (p>0.05). In patients, there was no significant correlation between inflammatory markers and level of serum irisin (p>0.05). CONCLUSION: Irisin, which is a myokine, was determined to have no significant role in the pathogenesis of FMS. Irisin had no association with disease activity and inflammatory markers. Also, the inflammation hypothesis was not supported, which suggested in FMS

Serum clara cell protein-16 level in non-smoker obstructive sleep apnea syndrome patients

European-Respiratory-Society (ERS) International Congress -- SEP 28-OCT 02, 2019 -- Madrid, SPAINWOS: 000507372407393…European Respiratory So

Serum Clara cell secretory protein (CC-16) in non-smoking patients with obstructive sleep apnea

PubMed ID: 32144590Objective: This study aimed to determine the association between the severity of obstructive sleep apnea (OSA) and serum Clara cell protein (CC16) levels in non-smoking patients with OSA. Methods: This prospective study included non-smoking patients who presented with sleep-related disturbances and underwent polysomnography (PSG). The serum CC16 level was measured and its relationship to PSG parameters was investigated. Results: The study included 128 patients (83 men) with a mean age of 48.4 ± 11.9. OSA was detected in 66 men (70%) and 29 women (30%) (p = 0.051). The severity of OSA was mild in 32 (25%), moderate in 28 (22%), and severe in 35 (27%) of the patients. There was no significant difference in CC16 levels between the OSA group (1746 ± 1006) and the OSA negative group (1721 ± 1201, p = 0.91) levels. There was no significant difference between the CC16 levels of the each four groups. Mean serum CC16 levels were significantly lower in OSA negative men than OSA positive men (777 vs 1462, p = 0.005). No significant difference was observed in CC16 values according to OSA severity in women. Conclusion: The serum CC16 level does not differ between non-smoking OSA patients and OSA negative patients. © 2020, Springer Nature Switzerland AG

Serum clara cell protein-16 level in non-smoker obstructive sleep apnea syndrome patients

European-Respiratory-Society (ERS) International Congress -- SEP 28-OCT 02, 2019 -- Madrid, SPAINWOS: 000507372407393…European Respiratory So

The relationship between serum leptin level and disease activity and inflammatory markers in fibromyalgia patients

Ankarali, Handan Camdeviren/0000-0002-3613-0523WOS: 000434665900003PubMed: 30374474OBJECTIVE: The aim of this study was to investigate whether there is a correlation between serum leptin level, disease activity and inflammation markers in patients with fibromyalgia syndrome (FMS). METHODS: A total of 48 patients with FMS diagnosed according to the 1990 American College of Rheumatology criteria were included in the study, as well as 36 healthy women as controls. The Visual Analogue Scale was used to gauge pain severity, the Fibromyalgia Impact Questionnaire was used to assess physical function, the 36-Item Short Form Health Survey was used to examine quality of life, and depression was measured with the Beck Depression Inventory. Blood samples were examined for erythrocyte sedimentation rate (ESR), C-reactive protein level (CRP), high-sensitivity CRP level (hsCRP), the neutrophil-tolymphocyte ratio (NLR), and the serum leptin level was determined using the enzyme-linked immunosorbent assay method. RESULTS: The serum leptin level in patients with FMS was significantly higher than in the healthy group. However, no significant relationship was found between leptin level and clinical and inflammatory parameters. In addition, there were no significant differences between the patients and the control group in measurements of ESR, CRP, hsCRP, or NLR. CONCLUSION: A higher serum leptin level in patients with FMS suggested that leptin may play role in the pathogenesis of FMS, yet there was no relationship between leptin and clinical and inflammatory parameters, suggesting that leptin is not an indicator of disease activity in FMS. Additional research should be performed with larger patient groups

Ankilozan spondilit hastalarında nötrofil- lenfosit oranı

Amaç: Bu çalışmanın amacı, ankilozan spondilit (AS) hastalarındaki inflamasyon ile nötrofil -lenfosit oranı (NLO) arasındaki ilişkiyi belirlemektir. Yöntem: Ankilozan spondilit tanılı 40 hasta ve 30 sağlıklı gönüllü çalışmaya dahil edildi. Tüm veriler yatan ve poliklinik hasta kayıt veritabanından elde edildi. Tüm olguların Bath Ankilozan Spondilit Hastalık Aktivite İndeksi (BA S- DAI), tam kan sayımı (TKS), CRP ve ESHı da kapsıyan ayrı ntılı fizik muayene ve laboratuvar bulguları kaydedildi. Lenfosit ve nötrofil sayısı otomatik TKSnin bir parçası olarak ölçüldü. Bulgular : Akut-faz reaktanı olan CRP ve ESH kontrol gr ubuna göre hasta grubunda anlamlı olarak daha yüksekti (p 0.05). Sonuç : Bu çalışmada NLO düzeylerinin AS hastalarında sağlıklı bireylere göre anlamlı olarak yüksek olmadığı görüldü. Bu sonuç NLOnun AS hastalarında sistemik in flamasyonu değerlendirmede uygun bir ölçü birimi olmad ığını götermektedir. Bizim elde ettiğimiz bu ön sonuçların daha ileri çalışmalarla tamamlanması gerektiğine inanıyoruz.Objective : The purpose of the present study is to determine the association between neutrophil -lymphocyte ratio (NLR) and inflammation in ankylosing spondylitis (AS). Method : Forty patients with ankylosing spondylitis and 30 healthy volunteers were included in the study. All data were obtained from patient registry database from in -patient and out-patient clinics. Detailed physical examination, and Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) were record ed. Complete blood count (CBC), CRP and ESR were performed recorded as laboratory tests in all participants. Lymphocyte and neutrophil counts were measured as part of the automated CBC. Results : The CRP, which is an acute -phase reactant, and ESR were signi ficantly higher in the patient group than those in the control group (p0.05). Conclusion : We observed that NLR levels werent significantly higher in AS patients compared to healthy individuals. NLR hasnt seem a reasonable measure to detect systemic infla m- mation in AS patients. We believe that our preliminary results need to be complemented with further studies